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Heart Rhythm. 2018 Jun;15(6):841-846. doi: 10.1016/j.hrthm.2018.02.008. Epub 2018 Feb 8.

Techniques for successful early retrieval of the Micra transcatheter pacing system: A worldwide experience.

Author information

1
Division of Cardiovascular Medicine, Department of Internal Medicine, Electrophysiology Section, Ross Heart Hospital, The Ohio State University Wexner Medical Center, Columbus, Ohio.
2
University of Michigan, Ann Arbor, Michigan.
3
Mayo Clinic, Rochester, Minnesota.
4
National Heart Institute, Kuala Lumpur, Malaysia.
5
OhioHealth Heart and Vascular Physicians, Section of Electrophysiology, Riverside Methodist Hospital, Columbus, Ohio.
6
Medtronic Inc, Minneapolis, Minnesota.
7
Johns Hopkins University, Baltimore, Maryland.
8
Emory University, Atlanta, Georgia.
9
Institute of Cardiology, Warsaw, Poland.
10
Weill Cornell Medical College, New York, New York.
11
University of Wisconsin, Madison, Wisconsin.
12
North Shore University Hospital, New York, Manhasset.
13
Yale University, New Haven, Connecticut.
14
Vanderbilt University, Nashville, Tennessee.
15
University of Leeds, West Yorkshire, England.
16
University of Kansas Medical Center, Kansas City, Kansas.
17
Division of Cardiovascular Medicine, Department of Internal Medicine, Electrophysiology Section, Ross Heart Hospital, The Ohio State University Wexner Medical Center, Columbus, Ohio. Electronic address: ralph.augostini@osumc.edu.

Abstract

BACKGROUND:

Experience with retrieval of the Micra transcatheter pacing system (TPS) is limited because of its relatively newer technology. Although abandonment of the TPS at end of life is recommended, certain situations such as endovascular infection or device embolization warrant retrieval.

OBJECTIVE:

The purpose of this study was to report the worldwide experience with successful retrieval of the Micra TPS.

METHODS:

A list of all successful retrievals of the currently available leadless pacemakers (LPs) was obtained from the manufacturer of Micra TPS. Pertinent details of retrieval, such as indication, days postimplantation, equipment used, complications, and postretrieval management, were obtained from the database collected by the manufacturer. Other procedural details were obtained directly from the operators at each participating site.

RESULTS:

Data from the manufacturer consisted of 40 successful retrievals of the Micra TPS. Operators for 29 retrievals (73%) provided the consent and procedural details. Of the 29 retrievals, 11 patients underwent retrieval during the initial procedure (immediate retrieval); the other 18 patients underwent retrieval during a separate procedure (delayed retrieval). Median duration before delayed retrieval was 46 days (range 1-95 days). The most common reason for immediate retrieval was elevated pacing threshold after tether removal. The most common reasons for delayed retrieval included elevated pacing threshold at follow-up, endovascular infection, and need for transvenous device. Mean procedure duration was 63.11 ± 56 minutes. All retrievals involved snaring via a Micra TPS delivery catheter or steerable sheath. No serious complications occurred during the reported retrievals.

CONCLUSION:

Early retrieval of the Micra TPS is feasible and safe.

KEYWORDS:

Cardiac implantable electronic device; Elevated threshold; Leadless pacemaker; Micra transcatheter pacing system; Retrieval

PMID:
29427820
DOI:
10.1016/j.hrthm.2018.02.008
[Indexed for MEDLINE]

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